Meals on Wheels budget cuts: 'Slowly developing crisis'

Manager and cook Michael Miller and nutrition budget director Karen Janousek of a senior meal program in South Dakota already work on shoestring budget.

Air traffic controllers got a reprieve from federal budget cuts when Congress felt public pressure after airport delays inconvenienced travelers.

But few expect a pardon for Meals on Wheels programs, which provide food and human contact for people over 60 who are physically housebound, socially isolated or very low income -- and in many cases, all three.

"They don't have high-priced lobbyists," said Alan Winstead, the executive director of Meals on Wheels of Wake County in Raleigh, N.C.

As it is,Meals on Wheels is estimated to serve just a third or so of the 25 million people over 60 who are poor or near poor.

Federal funding for Meals on Wheels and related nutrition services accounted for 0.02% of the U.S. budget last year. This year, the programs will have to do with roughly $38.7 million less because of the so-called sequester, which requires uniform cuts across programs regardless of cost-effectiveness.

The cuts are only starting to ripple through the system but programs have begun limiting who they serve and are planning for other ways to pull back. How many fewer meals might be offered as a result? A conservative estimate is 4 million, which comes from the White House. But the Meals on Wheels Association of America puts the number as high as 19 million.

"It's a slowly developing crisis," said Martha Roherty, executive director of the National Association of States United for Aging and Disability.

Meals on Wheels programs typically home deliver a prepared hot meal five days a week and also offer meals to seniors at community centers.

But the value of the service goes well beyond providing nutrition to a vulnerable population, advocates say.

"It's also a wellness check to make sure [the senior] is staying hydrated and is safe and secure," Roherty said.

The social aspect of the program is key, particularly at community centers, where in addition to meals, seniors might stay for card games or movies.

It's a program that pays off for taxpayers too, advocates say.

Research from Brown University found that the more states spend on programs like Meals on Wheels, the lower their percentage of nursing home residents with low-care needs.

Medicaid home care, which an independent senior may require, costs far less ($15,371 a year) than a Medicaid-paid nursing home ($57,878 a year).

As a result, the new federal funding cuts for the home delivery portion of Meals on Wheels could end up costing taxpayers at least $479 million this year alone, according to estimates by the Center for Effective Government, a federal budget watchdog.

No stranger to budget cuts -- especially at the state level -- the directors of programs in several states told CNNMoney that every year they find themselves doing more with less as the needs keep increasing.

Karen Janousek, the program's nutrition budget director, estimates it costs $8.20 to prepare and deliver every meal, including overhead such as utilities. About $3.30 of that comes from federal and state funding, plus a $3.50 donation from seniors who are able to pay it. So at best that leaves Janousek $1.40 short per meal, a difference her group tries to make up for through fundraising.

But being roughly 100 miles from the nearest Wal-Mart in an area that's not exactly overpopulated, fundraising doesn't always close the gap. And when it doesn't, a meal site may be closed down. Janousek estimates that across all of South Dakota, between 25 and 30 sites have been closed in the past few years.

Another program, in Pensacola, Fla., has already stopped delivering hot meals daily because of prior budget cuts. Instead it delivers a box worth of five frozen meals to seniors once a week.

Obama: Forced budget cuts are 'dumb'

So how will programs already operating on a shoestring handle this year's federal cuts?

For many, it remains unclear exactly how much their budgets will be cut, because they've only been given estimates about what to expect.

Many programs are already turning away eligible applicants, instead putting them on waiting lists. They're considering reducing the number of days meals sites are open. They're trying to raise more money.

One group in Roanoke, Va., plans to cut its emergency bag meals for holidays and bad weather, said Michelle Daley, the director of nutrition programs from Roanoke's Local Office on Aging. Those emergency bags typically cover about 13,500 meals a year.

Programs may need to take more drastic measures once they figure out how hard they'll be hit.

"It's exasperating that Congress ends cuts for programs because they inconvenience people but is cutting ours, which is saving lives and saving money," said Larry Tomayko, chief of staff for the Meals on Wheels Association of America.